JOHN ROBERT PRAIN (NPI# 1396867420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396867420 |
| Entity Type | Individual |
| Full Name | JOHN ROBERT PRAIN |
| Credential | CADC |
| Practice Address |
900 S Deer Rd Macomb IL 61455-2639 |
| Mailing Address |
Po Box 566 Avon IL 61415-0566 |
| Practice Telephone | 3098374876 |
| Practice Fax Number | 3098331531 |
| Mailing Telephone | 3094653949 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2009-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 22822 | IL | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
22822 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CADC | 22822 | 01 |
| IL | FEIN BWAY, INC | 370984175 | 01 |
| Street Address |
900 S DEER RD |
| City | MACOMB |
| State | IL |
| Zip Code | 61455-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394295 | Aimee Anderson | Counselor | 900 S Deer Rd, Macomb, IL 61455-2639 | 2018-11-06 |
| 1902385222 | Crystal D Stimpson | Registered Nurse | 900 S Deer Rd, Macomb, IL 61455-2639 | 2018-08-08 |
| 1588032460 | Illinois Medicaid-substance Abuse Macomb | Counselor | 900 S Deer Rd, Macomb, IL 61455-2639 | 2015-09-09 |
| 1457625592 | Amanda Michele Bolte | Counselor | 900 S Deer Rd, Macomb, IL 61455-2639 | 2012-03-07 |
| 1821217084 | Kathleen E Markey | Registered Nurse | 900 S Deer Rd, Macomb, IL 61455-2639 | 2007-04-25 |
| 1518185925 | Bridgeway Inc | Psychiatry & Neurology | 900 S Deer Rd, Macomb, IL 61455-2639 | 2007-04-23 |
| 1629292156 | Rachelle D Mccoy | Registered Nurse | 900 S Deer Rd, Macomb, IL 61455-2639 | 2007-04-13 |
| 1629292123 | Dorothy J Loop | Registered Nurse | 900 S Deer Rd, Macomb, IL 61455-2639 | 2007-04-13 |
| 1982827499 | Bridgeway, Inc | Community/Behavioral Health | 900 S Deer Rd, Macomb, IL 61455-2639 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869944 | Wesley Village, Inc | Speech-Language Pathologist | 1200 East Grant Street, Macomb, IL 61455 | 2019-09-04 |
| 1780154013 | Hannah Lauren Bengtson | Optometrist | 820 E. Jackson St., Macomb, IL 61455 | 2018-11-29 |
| 1255832564 | Lifeguard Ambulance Service of Illinois Inc. | Ambulance | 219 W Jackson St, Macomb, IL 61455 | 2018-02-22 |
| 1821516816 | Michelle Deann Sargeant | Speech-Language Pathologist | 315 N. Bonham, Macomb, IL 61455 | 2017-08-30 |
| 1972020360 | Kara Marie Wright | Speech-Language Pathologist | 315 N. Bonham St., Macomb, IL 61455 | 2017-08-25 |
| 1720356504 | Dawn M. Kedzior | Social Worker | 103 South Johnson Street, Macomb, IL 61455 | 2011-12-07 |
| 1255632642 | Michael Kurt Sharp | Audiologist | Memorial Hall, Second Floor, W Murray St, Macomb, IL 61455 | 2010-11-16 |
| 1952538704 | Mary L. Smith | Developmental Therapist | 1 University Circle, Western Il Univ, Cntr for Best Practices In Early Childhood Education, Macomb, IL 61455 | 2009-06-19 |
| 1982857827 | Macomb Oncology Institute Ltd | Radiology | 401 East Grant Street, Macomb, IL 61455 | 2008-10-23 |
| 1245488345 | Sonja E Schmidt | Social Worker | 119 Wetzel Hall, Western Illinois University, Macomb, IL 61455 | 2008-09-03 |
| Find all providers in zip 61455 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508350323 | Jennifer Prantera | Counselor | 45863 Waterside Dr Apt 9311, Macomb, MI 48044-5340 | 2018-06-15 |
| 1013373869 | Joey Rogers | Counselor | 38324 Sing Rd, Macomb, OK 74852-5753 | 2016-01-10 |
| 1386036432 | Lisa Papiez | Counselor | 51583 Iroquois Trl, Macomb, MI 48042-4260 | 2015-02-26 |
| 1811311913 | Lisa M Montalto | Counselor | 49668 Yale Dr, Macomb, MI 48044-1785 | 2014-02-10 |
| 1043645120 | Jennifer S Laboda | Counselor | 54583 Joseph Ronald Dr, Macomb, MI 48042-2329 | 2013-09-09 |
| 1861776213 | Bridgeway Inc | Counselor | 590 S Deer Rd, Macomb, IL 61455-2604 | 2011-10-04 |
| 1811194376 | William L Syrcle | Counselor | 103 S Johnson St, Macomb, IL 61455-2134 | 2007-06-28 |
| 1871632794 | Counseling Perspectives, LLC | Counselor | 516 E Jackson St, Macomb, IL 61455-2311 | 2007-02-06 |
| 1578662334 | Mona S Johnston | Counselor | 70 Flax Road, Macomb, IL 61455-8962 | 2006-09-21 |
| 1184244212 | Agrusa Counseling Center Pllc | Counselor | 16651 21 Mile Rd, Macomb, MI 48044-2603 | 2020-04-18 |
| Find all providers in MACOMB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.